Effects of extracorporeal shock wave therapy on motor function in patients with cerebral palsy: a systematic review and meta-analysis

Purpose: This study aims to evaluate extracorporeal shockwave therapy (ESWT) on spasticity, balance, gait patterns, and motor function in individuals with cerebral palsy (CP). Materials and methods: PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched up to 11 April 2025. Meta-analyses were conducted using Review Manager. The primary outcomes were Modified Ashworth Scale (MAS) and gait speed. Results: Ten randomized controlled trials (RCTs) involving 341 individuals with CP were included. Comparison between the ESWT and control groups revealed significant improvements in MAS (standardized mean difference [SMD]: −0.84, 95% confidence intervals [CIs]: −1.23 to −0.46, p < 0.001), gait speed (MD: 0.12, 95% CI: 0.02–0.23, p = 0.02), cadence (MD: −3.01, 95% CI: −6.03 to 0, p = 0.05), stride length (MD: 0.22, 95% CI: 0.16–0.28, p < 0.001), Pediatric Balance Scale (MD: 2.3, 95% CI: 0.4–4.19, p = 0.02), and Gross Motor Function Measure-88 (MD: 9.72, 95% CI: 7.36–12.08, p < 0.001). Conclusions: Combining ESWT with conventional physiotherapy, botulinum toxin type A (BTX-A) injection, or ankle-foot orthotics positively affects spasticity, gait, balance, and motor function. In addition, spasticity significantly decreases, particularly with focused ESWT or ESWT targeting the upper limbs.